Study on relationship between platelet transfusion efficacy and KIR-HLA receptor-ligand compatibility / 中国输血杂志

【Objective】 To study the correlation between platelet transfusion efficacy and KIR receptor-HLA ligand. 【Methods】 Thirty-three leukemia patients with positive HLA antibody were tested for cross-matching with donor platelets. Platelets from suitable donors were selected for transfusion, and the 24-hour platelet corrected count increment (CCI) was used to determine the transfusion effect. KIR and ligand genotyping were performed on blood samples from patients and donors by PCR-SSP method, and the relationship between platelet transfusion effects and KIR receptor-HLA ligand was analyzed. 【Results】 In 74 occasions of platelet transfusion, 42 were ineffective and 32 were effective. When the donor had C2 gene and HLA-B Bw4-80T gene, the frequency of ineffective platelet transfusion in the recipient was 69.0% (29/42) and 52.4% (22/35), respectively, which was significantly higher than that in the effective group [25.0% (8/32) and 25.0% (8/32)]. When the donor had C1 gene, and the frequency of effective platelet transfusion in the recipient was 100.0%(32/32), which was higher than that in the ineffective group [83.3%(35/42)]. When the recipient-donor matching mode was KIR2DL1-C2 and KIR3DL1-(HLA-B Bw4-80T), the frequency of ineffective platelet transfusion was 69.0%(29/42) and 40.5%(22/42),higher than that of the effective group [25% (8/32) and 18.8% (6/32)]. When the recipient-donor matching model was KIR2DL3-C1, the rate of effective platelet transfusion in 32 patients (100.0%), which was higher than that (35 patients 83. 3%) in the ineffective group. When the mismatch mode of recipient iKIR+donor HLA ligand receptor was KIR2DL1-C2, the frequency of effective platelet transfusion in the recipient was 78.1% (25/32), which was much higher than that in the ineffective group [31.0% (13/42)]. When the mismatch mode was KIR3DL1-(HLA-B Bw4-80T), the rate of effective platelet transfusion in the recipient was 68.8% (22/32), which was higher than that in the ineffective group (42.9%, 18/42). The difference between the above groups was statistically significant(P<0.05). 【Conclusion】 HLA-C1 and HLA-C2 genes are the key factors affecting the efficacy of platelet transfusion.For platelet refractorines, HLA-C1 is the protective gene, while HLA-C2 and HLA-B Bw4-80T are the susceptible genes. The recipient iKIR+donor HLA ligand receptor model may play an important role in platelet refractoriness.

Particulate matter concentration and related factors in accommodation places in 2016-2021 / 公共卫生与预防医学

Objective To understand the indoor particulate matter concentration in accommodation places in Liuzhou City, and to analyze the change rule and influencing factors of the concentration. Methods Eighteen hotels in Liuzhou were selected as monitoring objects by stratified random sampling method, and indoor particulate matter concentration and related factors were monitored from 2016 to 2021. Results The indoor PM2.5 concentration was 33(20-49) μg/m3, and the qualified rate was 89.1%. The concentration of PM10 was 70 (42-102) μg/m3, and the qualified rate was 88.6%. There were significant differences in indoor PM2.5 and PM10 mass concentration and qualification rate in different years (P2.5 and PM10 concentrations were the highest in winter and spring, and the lowest in summer, with a statistically significant difference (P2.5 concentration was highly correlated with PM10 concentration (r=0.996, P2.5 and PM10 concentrations were positively correlated with CO, total number of bacteria in the air, CO2, and noise, and negatively correlated with temperature. Multivariate regression analysis showed that there was a high positive correlation between indoor PM2.5 and PM10 mass concentrations, which was correlated with seasons (P2.5 and PM10 mass concentrations.

Comparison of random forests and SARIMA in Predicting Brucellosis Incidence / 公共卫生与预防医学

Objective To compare the effects of random forest and SARIMA (Seasonal Autoregressive Integrated Moving Average) on predicting incidence rate of brucellosis. Methods Using Brucellosis cases reported in the China Disease Prevention and Control Information System from 2005 to 2017, two models, random forest and SARIMA, were established for training and forecasting, and the forecasting results of the two models were compared. Results The R2 (R Squared) and RMSE (Root Mean Squared Error) of SARIMA model and random forest model are 0.904, 0.034351, 0.927 and 0.03345 respectively. Conclusion Both models have high prediction accuracy and can predict the incidence of brucellosis. Random forest prediction is a little bit better than SARIMA model and has more practical value.

Investigation and analysis of drinking water quality in rural areas of Liuzhou City in 2018-2020 / 公共卫生与预防医学

Objective To understand the hygienic status of rural drinking water quality in Liuzhou City from 2018 to 2020, and to provide basic data for the government to formulate relevant policies. Methods The monitoring data of rural drinking water from 2018 to 2020 in Liuzhou City was collected and statistically analyzed. Results A total of 1 877 rural drinking water samples were collected from 2018-2020. The total qualification rate of the monitored samples was 69.26% (1 300/1 877). By chi-square test, the qualification rate of the water samples in different years showed an upward trend (χ2=39.548，P=0.000). The qualification rate in dry season (63.59%) was significantly lower than that in flood season (75.11%)(χ2=29.240，P=0.000). The qualification rate of microbiological indicators (71.12%) was obviously lower than that of other indicators, and the difference was statistically significant (χ2=1.062，P=0.000). The qualification rate of finished water (69.44%) was slightly higher than that of tap water, but the difference was not statistically significant (χ2=0.037，P=0.848). Conclusion Microbial contamination is the main hygienic problem in rural drinking water quality in Liuzhou area, which should be paid attention to by relevant authorities.

Efficacy and Safety of Selegiline for Parkinson ’s Disease ：A Reevaluation of Systematic Reviews / 中国药房

OBJECTIVE：To conduct reevaluation of systematic review/Meta-ana lysis on the efficacy and safety of selegiline in the treatment of Parkinson ’s disease （PD）. METHODS ：Retrieved from PubMed ，Embase，Cochrane L ibrary，CNKI，Wanfang database as well as official websites of domestic and foreign health technology assessment institutions ，based on manual retrieval and review of references ，systematic review/Meta-analysis on selegiline alone or combined with other anti-PD drugs （trial group ） versus placebo or blank control or other anti-PD drugs （control group ）were collected. The time limit was from database inception to November 2020. After literature screening and data extraction ，PRISMA statement was adopted to evaluate the quality of the included reports. AMSTAR 2 scale was used to evaluate the methodological quality ，and GRADE method was adopted to evaluate the evidence quality ，the outcome indicators of the included studies were summarised and analyzed. RESULTS ：A total of 12 systematic reviews/Meta-analysis were included ，involving 4 systematic reviews and 8 Meta-analysis；there were 31 outcome indexes in total. PRISMA scores of them ranged from 16.5 to 27.0，including 15.0 to 21.0 for 2 literatures（16.67％）and 22.0 to 27.0 for 10 literatures（83.33％）. Results of AMSTAR 2 scale showed that the methodological qualities of 2 literatures were classed as high quality ，3 as low quality and 7 as very low quality. Results of GRADE evidence quality evaluation showed that 1 evidence quality was high-level ，3 were medium-level ，5 were low-level ，21 were very low-level ，and 1 was no evaluable . The main factors leading to the degradation were bias risk （87.10％），publication bias （77.42％），inaccuracy （51.61％）and incon sistency（41.94％）. In terms of therapeutic efficacy ，compared with control group ，selegiline could improve the total score of UPDRS ，UPDRS Ⅰ score，UPDRS Ⅱ score，UPDRS Ⅲ score and Webster score in patients with Parkinson ’s disease，either monotherapy or in combination with other anti-PD drugs （P＜0.05）. In terms of safety ，there was no significant difference in the incidence of adverse events or mortality between 2 groups（P＞0.05），but the rate of withdrawal due to adverse events was higher（P＜0.05）. CONCLUSIONS ：Selegiline is effective and safe in the treatment of Parkinson ’s disease ，but current methodological quality and evidence quality of included systematic reviews /Meta-analysis are low，which requires further standardization of research methods.

Anti-Yo-associated paraneoplastic cerebellar degeneration in a man with gastric adenocarcinoma: one case report and literature review / 中华神经科杂志

A male patient of acute onset is reported, whose main clinical manifestations were ataxia and dysarthria, with elevated carcinoembryonic antigen, non-small cell lung cancer antigen, carbohydrate antigen 72-4, positive anti-Yo antibody. The patient′s gastroscopy and biopsy result suggested gastric cancer, and his symptoms got better after radical surgery. Anti-Yo-associated paraneoplastic cerebellar degeneration complicated with gastric adenocarcinoma was diagnosed. If encountering cases of ataxia or dysarthria in clinical work, the possibility of paraneoplastic cerebellar degeneration should be considered and evidence for tumor should be searched, so as to avoid missed diagnosis or misdiagnosis.

Effects of patient participation -based dietary intervention on nutritional status for patients with severe burns / 中国实用护理杂志

Objective:To explore the influence of patient participation-based dietary intervention on nutritional status for patients with severe burn.Methods:From September 2017 to January 2019, 60 severe burn patients hospitalized in the department of burn and plastic surgery of Qingdao Municipal Hospital were recruited and divided into the experimental group ( n=30) and the control group ( n=30) according to the random number table method. The control group received a regular diet. While the experimental group received a patient participation-based dietary intervention(PPDI), The wound healing time and the value of nutritional status index, such as height, body mass index(BMI), serum albumin, serum prealbumin, in the two groups on admission, at 2 weeks after intervention, 4 weeks after intervention were compared. The nutritional knowledge questionnaire of burn patients and "3-day diet diary" were used for investigation. Results:The score of nutritional knowledge showed no significant difference between the two groups before intervention. After intervention, the score of nutritional knowledge in the experimental group was 21.40±2.42, significantly higher than that in the control group (19.00±2.26) ( t value was 3.975, P<0.01). For time effect and between-group effect, there were significant difference in serum albumin between two groups ( F values were 9.232, 4.651, P<0.05); the time effect and between-group effect of serum prealbumin were statistically significant ( F values were 11.592, 6.228, P < 0.05). The wound healing time in the experimental group was significantly lower than that in the control group ( t value was -3.801, P<0.01). Conclusions:Patient participation-based dietary intervention can effectively enhanced the level of nutritional knowledge, improved nutritional status, shortened wound healing time among patients with severe burn.

Research progress of the mechanism in contrast-induced acute kidney injury in the context of diabetes mellitus / 中国介入影像与治疗学

With the development of radiology, the application of contrast agent is more frequent, and the incidence of contrast-induced acute kidney injury (CI-AKI) is increasing. At present, the pathogenesis of CI-AKI is not completely clear, especially of CI-AKI in the context of diabetes mellitus (DM). The high glucose state in DM may promote CI-AKI. The research advances of the mechanism of CI-AKI in the context of DM were reviewed in this article.

Progress of diagnosis and treatment of isolated superior mesenteric artery dissection / 中国介入影像与治疗学

Isolated superior mesenteric artery dissection (ISMAD) is a rare disease without characteristic symptoms and physical signs, therefore easily to be misdiagnosed or missed diagnosis. In recent years, the detectable rate of ISMAD has increased due to the development of medical imaging techniques. The progress of pathogenesis, clinical features, imaging classification and treatment were reviewed in this article.

Relation of perceived social support, job insecurity and psychological distress among clinical nurses / 中国实用护理杂志

Objective@#To examine the potential mediating effect of perceived social support on job insecurity and psychological distress among clinical nurses.@*Methods@#A total of 462 clinical nurses in Shandong Province were selected by convenience sampling method. They were assessed with job insecurity scale, perceived social support and 10-item Kessler Psychological Distress Scale (K10) for the evaluation of job insecurity, self-esteem and psychological distress.@*Results@#The mean score of K10 was (23.72±7.22) points among clinical nurses, and 85.9% (397/462) of them had psychological distress problems. The K10 scores were positively correlated with the scores of job insecurity (r=-0.282, P<0.01), and the K10 scores were negatively correlated with perceived social support scores (r = -0.282, P<0.01). Job insecurity was negatively correlated with perceived social support (r = -0.365, P<0.01). The confidence interval from Bootstrap method indicated perceived social support played a partial mediating role between job insecurity and psychological distress, and the value of mediating effect was 13.7%.@*Conclusion@#The relation of perceived social support to job insecurity and psychological distress among clinical nurses are intimate. Perceived social support might mediate the relationship between job insecurity and psychological distress.

Reconsideration of indications for gallbladder-preserving cholecystolithotomy and preventive measures for postoperative recurrence of gallstones / 临床肝胆病杂志

Choledochoscopic minimally invasive gallbladder-preserving cholecystolithotomy is a surgical method for preserving the gallbladder in the treatment of gallstones, and recurrence of gallstones is a hot topic for gallbladder-preserving cholecystolithotomy. The postoperative recurrence rate of gallstones can be reduced by selecting appropriate surgical indications and adopting effective preventive measures after surgery. This article reviews the indications for minimally invasive gallbladder-preserving cholecystolithotomy and postoperative preventive measures for the recurrence of gallstones, in order to better understand the influencing factors for recurrence and provide guidance for the treatment of gallstones by minimally invasive gallbladder-preserving cholecystolithotomy.

Reconsideration of indications for gallbladder-preserving cholecystolithotomy and preventive measures for postoperative recurrence of gallstones / 临床肝胆病杂志

Choledochoscopic minimally invasive gallbladder-preserving cholecystolithotomy is a surgical method for preserving the gallbladder in the treatment of gallstones, and recurrence of gallstones is a hot topic for gallbladder-preserving cholecystolithotomy. The postoperative recurrence rate of gallstones can be reduced by selecting appropriate surgical indications and adopting effective preventive measures after surgery. This article reviews the indications for minimally invasive gallbladder-preserving cholecystolithotomy and postoperative preventive measures for the recurrence of gallstones, in order to better understand the influencing factors for recurrence and provide guidance for the treatment of gallstones by minimally invasive gallbladder-preserving cholecystolithotomy.

Effect of different fixation methods on cervical curvature and axial symptoms in posterior cervical single?door surgery / 中国综合临床

Objective To observe the effect of different fixation methods on cervical curvature and axial symptoms in posterior cervical single?door surgery??Methods From September 2014 to February 2016, 112 patients with multi?segment cervical spondylotic myelopathy underwent surgical treatment in Handan Central Hospital of Hebei Province??According to the lamina fixation methods,they were divided into groups A,B and C??There were 35 cases in group A,using suture suspension method to fix lamina; 34 cases in group B,using anchor suspension to fix lamina;and 43 cases in group C,using mini?titanium plate to fix lamina The operation time,intraoperative blood loss,laminae open angle,spinal drift distance,postoperative neurological recovery,cervical curvature index ( CCI ) and occurrence of axonal symptoms were compared in each group??Results All patients underwent surgery successfully??There were no significant differences in operation time,intraoperative blood loss,laminae open angle and spinal drift distance between the 3 groups (all P＞0??05)??The JOA score of group A was (7??9± 2??2) preoperatively,(9??3± 2??8) at 3 months after surgery,and (13??9±3??4) at the final follow?up??In Group B was (7??7±2??0) preoperatively,(9??1±2??7) at 3 months after surgery,and (13??6±3??7) at the final follow?up??In Group C was (7??8±2??1),( 9??0±2??6) and (13??8 ± 3??5 ), respectively, there were significant differences before and after operation ( Fintra?grouP＝7??271, Pintra?grouP ＜ 0??001; Finter?grouP ＝ 11??372, Pinter?grouP ＜ 0??001; Finteraction ＝ 9??831, Pinteraction＜0??001)??The CCI of group A was ( 22??7± 5??6)% preoperatively,(20??5± 4??4)% at 3 months after surgery,and (16??6± 3??0)% at the final follow?up??The CCI of group B was ( 21??4 ± 5??2)%,( 19??7 ±4??1)% and (17??8±2??9)% respectively??The CCI of group C was ( 21??1 ± 5??0)%,( 20??8 ± 4??6)% and (19??8 ± 4??0)% respectively??There were significant differences between group A and group B in the last follow?up and the three months before and after operation??( all P＜0??05),there was no significant difference between groups C at different time points ( P＞0??05)??According to the visual analogue scoring system,the distribution of axial symptoms in group C was significantly better than that in group A and group B ( Z＝6??678;P＝0??035)??Conclusion Posterior single?door mini?titanium plate fixation can not only improve nerve function,but also prevent cervical curvature loss and reduce the occurrence of axonal symptoms??

Relation of perceived social support,job insecurity and psychological distress among clinical nurses / 中国实用护理杂志

Objective To examine the potential mediating effect of perceived social support on job insecurity and psychological distress among clinical nurses. Methods A total of 462 clinical nurses in Shandong Province were selected by convenience sampling method. They were assessed with job insecurity scale, perceived social support and 10-item Kessler Psychological Distress Scale ( K10) for the evaluation of job insecurity, self-esteem and psychological distress. Results The mean score of K10 was (23.72 ± 7.22) points among clinical nurses, and 85.9% (397/462) of them had psychological distress problems. The K10 scores were positively correlated with the scores of job insecurity (r=-0.282, P＜0.01), and the K10 scores were negatively correlated with perceived social support scores (r=-0.282, P＜0.01). Job insecurity was negatively correlated with perceived social support (r =-0.365, P＜0.01). The confidence interval from Bootstrap method indicated perceived social support played a partial mediating role between job insecurity and psychological distress,and the value of mediating effect was 13.7% . Conclusion The relation of perceived social support to job insecurity and psychological distress among clinical nurses are intimate. Perceived social support might mediate the relationship between job insecurity and psychological distress.

Significance of the items for Dizziness Handicap Inventory in differential diagnosis of benign paroxysmal positional vertigo / 中南大学学报(医学版)

To explore the value of items for the Chinese version of Dizziness Handicap Inventory (DHI) in differential diagnosis of benign paroxysmal positional vertigo (BPPV) in patients with vertigo or dizziness first coming to the outpatient clinic.
 Methods: A total of 322 patients with vertigo or dizziness, who came from Nanfang Hospital, Southern Medical University, were enrolled from April 2016 to February 2017. The Chinese version of DHI and Visual Analogue Scale (VAS) were completed by themselves. After detailed vestibular function examination, the patients were divided into a BPPV group, a normal vestibular group, and a abnormal vestibular group.
 Results: The score of DHI-2 in the BPPV group was 5.52±2.10, which was higher than that in the normal vestibular group (3.94±2.91)(t=3.847, P0.05).
 Conclusion: DHI-2 and DHI-item 13 should be included in the inquiry of disease history at the time of first diagnosis, which can be used to identify patients with BPPV quickly and effectively.

Roles of penA and mtrR gene mutations in in vitro-induced resistance of Neisseria gonorrhoeae to ceftriaxone / 中华皮肤科杂志

Objective To investigate the roles of penA and mtrR gene mutations in resistance of Neisseria gonorrhoeae to ceftriaxone.Methods Standard strains of Neisseria gonorrhoeae (ATCC-49226),clinical strains of Neisseria gonorrhoeae with high sensitivity to ceftriaxone (2012-4052 and 2012-15361) and clinical strains of Neisseria gonorrhoeae with reduced sensitivity to ceftriaxone (2012-5616) were treated with ceftriaxone at subinhibitory concentration (50％ MIC),so as to induce the resistance to ceftriaxone.DNA was extracted from the primary strains before the treatment and daughter strains resistant to ceftriaxone after the treatment,followed by the amplification and DNA sequencing of the penA and mtrR genes.Results For strains 2012-5616 and ATCC-49226,ceftriaxone-resistant strains with MIC ≥ 1 mg/L were obtained after 26 and 28 passages,respectively.For strains 2012-4052 and 2012-15361,ceftriaxone-resistant strains with MIC ≥ 0.5 mg/L were obtained after 22 and 36 passages,respectively.Sequence analysis of the penA gene revealed that A501T and G542S mutations were identified in the induced resistant ATCC-49226 strains,but no new mutations were observed in the other 3 strains.All the 4 mutant strains showed penicillin-binding protein 2 (PBP2) of gene sequence type ⅩⅧ and no mosaic structure of the penA gene was found in the strains.Sequence analysis of the mtrR gene showed that the A39T mutation was found in the 2012-5616 and ATCC-49226 strains before and after the induction,as well as in the coding region of the mtrR gene in the induced resistant 2012-4052 strains.Conclusion The A501T and G542S mutations in the penA gene and A39T mutation in the mtrR gene may play a role in the resistance of Neisseria gonorrhoeae to ceftriaxone.

New Concept of Medical Ethics Education Based on General Education / 中国医学伦理学

Combined with the purpose of medical ethics education , the influence of general education on social and cultural values of medical students , and the main problems of domestic ethics education , this paper put forward a new concept of medical ethics education based on general education .According to the characteristics of medical students, it also proposed a preliminary planning assumption of curriculum provision of general education , namely that general education should be mainly dominated by humanities science , which enable students to think independ-ently and critically and further to make a reasonable choice through comprehensive judgments of social and personal values in the face of medical ethics .

Curative effect of mosapride and Shugan Jieyu capsule in the treatment of functional dyspepsia and Influence on brain-gut peptide / 中国综合临床

Objective To investigate the curative effect and mechanism of mosapride and Shugan Jieyu capsule in the treatment of functional dyspepsia(FD).Methods One hundred and ten cases patients with FD were divided into two groups according to the digital random table method,with 55 cases in each group.The control group took mosapride tablets orally(5 mg/times,3 times/d,30 min before meals),the treatment group took with Shugan Jieyu capsule orally(2 pellets/times,2 times/d,orally with warm water on morning and evening)on the basis of treatment of the control group.Two groups were treated continuously for 4 weeks.The symptoms score and total effective before and after treatment were compared,and plasma Leptin(Leptin),Ghrelin and gastric dynamic element(MTL)levels of the two groups before and after treatment were compared.The two groups were followed up for 6 months after treatment,the recurrence rate of the two groups was compared.Results The symptoms integral of the treatment group after treatment was lower than that of the control group((4.97±1.85)points vs.(7.35±2.28)points,t=6.011,P＜0.01),the total effective rate was higher than that of the control group(94.5％(52/55)vs.81.8％(45/55),x2=4.274,P=0.039),the improvement of plasma Leptin((13.10±2.07)μg/L vs.(14.66±2.11)μg/L,t=3.914,P=0.001),Ghrelin((3.52±0.70)ng/L vs.(2.95±0.67)ng/L,t=4.363,P＜0.01),MTL((281.47±61.09)ng/L vs.(242.31±65.28)ng/L,t=3.248,P=0.002)levels were better than those of the control group,the recurrence rate of 6 months was lower than that of the control group(7.5％(5/53)vs.24.4％(11/45),x2=4.124,P=0.041),the difference was statistically significant.Conclusion Mosapride tablets combined with Shugan Jieyu capsule can benefit the liver symptom,and also can reduce the recurrence rate,it has curative effect on FD,its mechanism may be related to the improvement of BGP levels disorder in patients with FD.

The Current Status of Informatization Construction and Application in Provincial Disease Prevention and Control Institutions / 医学信息学杂志

The paper issues questionnaires to investigate the current status of informatization construction and application in 32 provincial disease prevention and control institutions of China,summarizes the current status of informatization organization and management,standard planning,capital input and allocation,analyzes the problems existing in the process of disease control informatization construction,focuses on the discussion of imbalanced regional development,insufficient capital input,lack of informatization personnel,and lack of informatization security awareness,and proposes corresponding suggestions and countermeasures.

New Concept of Medical Ethics Education Based on General Education / 中国医学伦理学

Combined with the purpose of medical ethics education , the influence of general education on social and cultural values of medical students , and the main problems of domestic ethics education , this paper put forward a new concept of medical ethics education based on general education .According to the characteristics of medical students, it also proposed a preliminary planning assumption of curriculum provision of general education , namely that general education should be mainly dominated by humanities science , which enable students to think independ-ently and critically and further to make a reasonable choice through comprehensive judgments of social and personal values in the face of medical ethics .